by Thomas A. Richards, Ph.D. Google+
Psychologist/Director, The Social Anxiety Institute


If a person usually becomes (irrationally) anxious in social situations, but seems better when they are alone, then “social anxiety” may be the problem.

The Third Largest Mental Health Care Problem



Specific and Generalized Social Anxieties



Symptoms of Social Anxiety Disorder


  • Being introduced to other people
  • Being teased or criticized
  • Being the center of attention
  • Being watched while doing something
  • Meeting people in authority (“important people”)
  • Most social encounters, especially with strangers
  • Interpersonal relationships, whether friendships or romantic

This list is certainly not a complete list of symptoms — other feelings have been associated with social anxiety as well.



People with social anxiety disorder know that their anxiety is irrational and does not make rational (i.e., cognitive) sense.  Nevertheless, “knowing” something is not the same thing as “believing” and “feeling” something.

Thus, for people with social anxiety, thoughts and feelings of anxiety persist and show no signs of going away — despite the fact that socially-anxious people “face their fears” every day of their lives.


Effective Therapy for Social Anxiety Disorder

The good news is that cognitive-behavioural therapy for social anxiety has been markedly successful.  Research and clinical evidence alike indicate that cognitive-behavioural therapy, which should be comprehensive in nature, produces permanent changes in the lives of people.

Social anxiety disorder can be overcome, although it takes both consistency and persistence. But, barring cognitive problems (e.g., dementia, Alzheimer’s Disease) everyone can make progress against social anxiety using the appropriate type of cognitive-behavioural therapy.

At The Social Anxiety Institute, we call cognitive-behavioural therapy for social anxiety disorder “comprehensive” cognitive-behavioural therapy, to differentiate it from the general idea that cognitive concepts are simplistic and can be addressed by using only a few strategies.

A successful therapy program for social anxiety disorder must address the dozens of cognitive methods, strategies, and concepts that will allow people’s brains (i.e., their brain associations or neural pathways) to literally change. The brain is continually learning, and irrational thoughts and beliefs can change as a result of this cognitive process.


How To Find Help for Social Anxiety Disorder

Social anxiety, as well as the other anxiety disorders, can be successfully treated. In seeking support for this problem, search for a specialist — someone who (a) understands this problem well and (b) knows from experience how to treat it.

Become an informed client and ask questions.  For example, does the therapist understand that you feel very self-conscious and that others are watching and forming a negative evaluation about you? – or do they minimise what you’re saying and just say, “No, No, No, you’re fine … you’re just exaggerating….” or expect you to go out and do unreasonable “exposures”?

It is true that we who have lived through social anxiety do realise our mind is many times irrational and we over-exaggerate, but it still FEELS like others are watching and judging us. Our self-consciousness is a feeling and it is very real.




Does your therapist say, “Face your fears and they’ll go away?”





But this can be stopped, quenched, and killed in a relatively short period of time – by finding a cognitive-behavioural therapist who understands and specialises in the treatment of social anxiety.

The most important elements in overcoming social anxiety

1. An understanding and awareness of the problem,

2. A commitment to carry through with cognitive-behavioural therapy even when it is repetitious and seems difficult,

3. Practice, practice, practice to get that information (i.e., cognitive methods, strategies, and concepts) deep down into your brain – so that these cognitive methods become habitual and automatic,


That is, the person who feels anxious while reading in public uses specific strategies to meet his goal, whereas the person who wants to learn how to make introductions and engage in small talk during social activities slowly works toward his or her goals.  Use role-plays, acting, the tape recorder and video camera, question and answer periods, mock job interviews, and doing foolish things deliberately as part of the behavioural therapy group for people with social anxiety.

Note: A ladder or “hierarchy” should be used as a flexible guide in planning. We want to practice, meet our goals, move up our expectations, until our goal is finally met.



You may be asking, “won’t people never make progress if they choose to do nothing each group?”  Here’s the secret: This has never happened.  People in the group understand why they are there and, despite an amount of anxiety that is naturally present, they voluntarily choose to work on their specific anxieties.  This is much more practical and real-life than being forced to do something.

Therapy groups for social anxiety should always be encouraging, positive, and supportive.  If the right atmosphere is set, people can make (and continue to make) progress up their “hierarchy” of social anxieties.


Today, cognitive-behavioural therapy is used to treat both forms of social anxiety.  With cognitive-behavioural therapy, we do not wallow in the past and continually bring it up — because it doesn’t do us any good.  Instead, we focus on present-day problems and symptoms and use many small techniques and methods to eradicate anxiety thinking, feelings, beliefs, and belief systems.


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